HYPNOTHERAPY has been around since Scottish neurosurgeon coined the term in the 1840s. About that time, British surgeon performed hundreds of abdominal and scrotal operations in India, using hypnosis as the only anaesthetic. It was unfortunate timing that he presented his papers on hypnosis to London鈥檚 Royal Society just as chemical anaesthetics were being discovered; the technique was not accepted by the medical establishment.
Today, although increasing numbers of people are consulting private practitioners, the lack of research into hypnotherapy means that it remains on the fringes of medicine. In a , the Science and Technology Committee of the UK鈥檚 House of Lords placed hypnosis in the 鈥減oor research/poor regulation鈥� category 鈥� therapies least likely to make it into mainstream medicine without dramatic changes.
If you search the using the term 鈥渉ypnotherapy鈥�, you get 11,518 hits, so there are plenty of studies out there. Unfortunately, most do not meet the gold standard of a randomised controlled trial (RCT), and instead take the form of reviews or case studies. In the past four years there have been only 91 relevant RCTs conducted worldwide. They suggest that hypnosis works in a wide range of situations, including pain control, smoking cessation, anxiety disorders and irritable bowel syndrome (IBS).
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There is also evidence that hypnosis has physiological effects as well as psychological ones: Peter Whorwell and his colleagues at the University of Manchester, UK, found that when used to treat IBS, hypnotherapy may help modulate gastrointestinal and even immune function (). But even for IBS, one of the best-covered areas, the mechanism of action is not clear and the , which assesses clinical trials, has criticised the quality and size of studies.
There are several reasons why so few good trials have been done, despite the evidence that hypnotherapy can at the very least reduce stress, anxiety and pain. The use of hypnosis on stage doesn鈥檛 help its image. The field also suffers the same problem as other 鈥渢alking鈥� therapies: drug companies have no incentive to carry out the expensive studies required, so alternative funding must be found.
One of the biggest obstacles to placing hypnosis on a more scientific footing, however, is the therapists themselves. They tend to argue that its effects are part of a unique interaction between practitioner and subject, and so cannot be made subject to the same testing criteria as would be expected for a drug. This debate has to end.
I agree that when faced with a living, breathing person, it is difficult to reduce the process of clinical hypnosis to a series of yes/no decisions that can be reliably repeated in other situations. But for hypnosis to become part of medicine, it must be made robust, replicable and measurable. We need to build up a body of clinical evidence acceptable to the medical profession.
鈥淔or hypnosis to be accepted in medicine, it has to be made robust, replicable and measurable鈥�
As well as standardising the protocols used, we need quantitative measures of the effects on the patient, so studies can be compared. Ideally, researchers would have access to state-of-the-art brain scanning equipment. More realistically, we can at least use simple biochemical markers of hypnosis and its after-effects.
To kick-start such research in the UK, my colleagues and I have formed the . In an article to appear in , I describe our plans to bring medical specialists and students together with hypnotherapists to conduct coordinated national trials and generate a large body of evidence, from studies replicated at multiple locations. One of the first questions we hope to answer, once and for all, is whether clinical hypnosis can reduce stress 鈥� a potentially significant component in all illness. We aim to use standardised questionnaires to assess lifestyle, stress and depression, and to measure levels of various stress hormones in saliva samples taken from study participants.
If we can show this stress reduction, we hope hypnosis will be offered to patients to reduce the anxiety of being ill. As it becomes more widely used, this could open up research into further benefits, including reducing the perception of pain and improving recovery times.
This is a plea for hypnosis not as an alternative to conventional medical therapies, but as a complementary practice, in the hands of qualified practitioners. As far as I鈥檓 aware, no one has ever died from being given hypnosis as a treatment. The same cannot be said for chemical anaesthesia. If this useful, safe and cheap procedure can be incorporated into medicine, it will benefit both patients and doctors. After all, who wants to be operated on by a stressed surgeon?
Forget the sideshow-Svengali image of hypnosis so cherished by the media 鈥� it鈥檚 time for clinical hypnosis to take its proper place in medicine.
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